Child Maltreatment Investigations in Canada: Main and Moderating Effects of Primary Caregiver Cognitive Impairment

Expectant parents with intellectual disabilities in child protection: Risk factors for child safety

BACKGROUND

Newborns of parents with intellectual disabilities face higher risks in their environment for child unsafety, despite parents' good intentions. To help parents prevent unsafe circumstances, a good understanding of the risk factors faced by these parents is needed.

METHODS

This casefile study examined (1) which risk factors were present for expectant parents with intellectual disabilities in child protection, (2) which domains of risk factors, and (3) whether a cumulation of risk factors was related to child safety.

RESULTS

Expectant parents with intellectual disabilities in child protection before the child was born often experienced a cumulation of risk factors. Child, family, and care factors best predicted child safety. A cumulation of risk factors over multiple life domains increased the risks for child unsafety.

CONCLUSIONS

To reduce the risks of unsafe parenting conditions for newborns, preventive interventions for expectant parents with intellectual disabilities should address their needs from an ecological perspective.

Explaining Risk Factors for Successful Family Supervision Orders: Families with Intellectual Disabilities in Child Protection in the Netherlands

Families with mild to borderline intellectual disabilities (MBID) are overrepresented in child protection, and are at higher risk for long and unsuccessful family supervision orders (FSOs). This is worrisome, as many children apparently are exposed to unsafe parenting situations for longer periods of time. Therefore, the present study examined which child and parental factors and child maltreatment are related to the duration and success of an FSO in families with MBID in the Netherlands. Casefile data were analysed of 140 children with an ended FSO. Results from binary logistic regression analyses showed that in families with MBID, young children, children with psychiatric problems, and children with MBID were at higher risk for a longer duration of FSOs. Furthermore, young children, children with MBID and children who were sexually abused had a lower chance of a successful FSO. Unexpectedly, children who witnessed domestic violence or whose parents were divorced, had a higher chance of a successful FSO. The discussion focuses on implications of these results for treatment and care of families with MBID from the perspective of child protection.

The first 1001 days: A scoping review of parenting interventions strengthening good enough parenting in parents with intellectual disabilities

There are concerns about parents' parenting skills with intellectual disabilities. However, it is reported that parents with intellectual disabilities show good enough parenting if they are supported effectively and in line with their needs. This scoping review identifies and critically evaluates preventive interventions for parents with intellectual disabilities and a cumulation of multiple and complex problems that aim to prepare them for good enough parenting. Six interventions were identified, with preliminary to strong indications of effectiveness. Although none of the interventions focused on all conditions of good enough parenting and only one intervention incorporated all seven key elements to effectively work with parents with intellectual disabilities, the limited evidence on the effectiveness of these interventions suggests that significant and societally relevant effects on parents' knowledge and skills can be attained. This suggests that more comprehensive early preventive interventions with rigorous evaluations can have a significant impact.

Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk

BACKGROUND

Parental mentalising difficulties are robustly linked to caregiving problems. Mothers with intellectual disability are at risk for caregiving problems, but knowledge on their parental mentalising abilities is lacking. The present study aimed to fill this gap.

METHOD

Thirty mothers with mild intellectual disability, and 61 comparison mothers with ADHD, were assessed for parental mentalising using the Parental Reflective Functioning Questionnaire. Contributions of intellectual disability, maternal exposure to childhood abuse/neglect and psychosocial risk to parental mentalising were examined through hierarchical regression analysis.

RESULTS

Mothers with intellectual disability had a heightened risk for parental mentalising difficulties, in the form of elevated prementalising. Intellectual disability and cumulative childhood abuse/neglect uniquely predicted prementalising among the mothers, whereas cumulative psychosocial risk added to the risk for prementalising specifically among mothers with intellectual disability.

CONCLUSIONS

Our findings support contextual models of caregiving, and suggest a need for mentalisation-based support for parents with mild intellectual disability.

Experiences of Interpersonal Trauma Among Parents With Intellectual Disabilities: A Systematic Review

Research has suggested highly elevated levels of interpersonal trauma (IPT) among parents with intellectual disabilities (ID), and that such experiences may contribute to the caregiving and child developmental problems often seen in this population. Conflicting results have however been reported, and there is no systematic review on this matter. This study therefore systematically reviewed the empirical evidence concerning (a) prevalence of IPT among parents with ID, and links with (b) caregiving-relevant and (c) child developmental outcomes, in accordance with the PRISMA 2020 guidelines. Searches were conducted in MEDLINE, CINAHL, PsycINFO, and PTSDpubs. Peer-reviewed empirical articles reporting exposure to any form of systematically assessed IPT (unspecified IPT, physical, sexual, and emotional abuse, neglect, prolonged childhood separations from caregivers, witnessing abuse in the family) among parents with ID were included, yielding a final selection of 20 studies. Findings consistently indicated markedly elevated levels of IPT among parents with ID, with a majority (>50%) having experienced some form of IPT. Estimates for both unspecified and specific forms were typically higher than corresponding estimates in other groups at elevated risk, and than meta-analytical general population estimates in comparable countries. Findings regarding caregiving-relevant outcomes were mixed but indicated links with adverse outcomes, particularly regarding parental mental health. Reports pertaining to child developmental outcomes were scant and inconsistent. We highlight important limitations in the extant literature and provide directions for future research and clinical practice.

Recurrence of Substantiated Maltreatment Reports between Low-Income Parents With Disabilities and Their Propensity-Score Matched Sample Without Disabilities

Using the Longitudinal Studies of Child Abuse and Neglect dataset, 127 low-income parents with disabilities and a propensity score matched sample of 254 parents without disabilities were compared for the rates of repeated substantiated child maltreatment allegations and potentially distinct risks for substantiated child maltreatment recurrence. The number of substantiated child maltreatment allegations was not significantly higher for low-income parents with disabilities (M = 1.17, SD = 1.83) than their matched sample (M = .93, SD = 1.44) (t = -1.29, p = .197). Findings from the negative binomial regression indicated that parental disability was also not a significant predictor for repeated substantiated child maltreatment allegations among low-income parents after controlling other risk factors (Exp(B) = 1.16, p < .353). In both groups, black parents were more likely to have repeated substantiated maltreatments than white parents. For parents with disabilities, being an older parent, receiving SNAP benefits, having a daughter, and having a child in continued out-of-home care significantly increased the risk for repeated substantiations while having a GED or higher education degree and living with a larger number of family decreased the risk. For parents without disabilities, family instability was the only additional risk factor for repeated maltreatment substantiations.

Accessibility of child protection investigations during pandemic: A qualitative analysis of court proceedings

BACKGROUND

Qualitative research using published court records to examine contextual factors that contribute to child protection decisions in cases involving parents with intellectual disabilities is limited, particularly during the COVID-19 pandemic.

METHOD

The present study conducted qualitative content analysis on 10 published Ontario court cases to study child protection decision-making between 2019 and 2021.

RESULTS

The findings corroborated previous literature with nine out of 10 cases resulting in loss of child custody. Four major themes emerged from content analysis: (1) Impact of COVID-19 pandemic on cases; (2) Systemic barriers to accessibility; (3) Attitudes and bias toward parents with intellectual disabilities; and (4) Ultimate reliance on intellectual disability status for final custody decision.

CONCLUSIONS

Conducting content analysis on published court cases is useful in learning about accessibility barriers for parents with intellectual disabilities and may help in understanding the impact of the COVID-19 pandemic on the child protection system.

Improving services for parents with intellectual disability and their families: Views of Canadian social service workers

How adults with intellectual disability fare in the parenting role depend, to varying degrees, on the adequacy of supports and services provided. The available research suggests that service providers are often ill-equipped to accommodate their support needs. The purpose of this qualitative descriptive study was to explore the perspectives of Canadian social service workers on what is required to improve services and build systems capacity to more effectively support parents with intellectual disability, their children and families. A total of 39 workers, identified by parents with intellectual disability as their key workers, were interviewed. To build systems capacity to support these parents and families, and to address institutionalised discrimination, key workers highlighted the need for entry-to-practice and continuing professional education to develop worker capabilities for reflective practice, relationship-building and research utilisation; accommodative caseload management, giving workers the time, flexibility and the professional supervision they need to deal with complexity and fashion individualised service responses; and, a common framework, with defined service pathways, to facilitate interagency case planning and, in turn, continuity in service provision. The question is not whether adults with intellectual disability can be effectively supported in the parenting role; the question is whether the political will exists to do what is necessary to ensure they are.

Parents with intellectual disability reporting on factors affecting their caregiving in the wake of the COVID‐19 pandemic: A qualitative study

Background

Parents with intellectual disability are vulnerable to parenting stress and overwhelming life events. The COVID‐19 pandemic constitutes a potentially overwhelming event, but there is little knowledge concerning the effects on parents' caregiving. The present study aimed to fill this gap.

Method

Semi‐structured interviews with 10 Swedish parents with intellectual disability were analysed using thematic analysis.

Results

One broad caregiving‐related theme: increased caregiving demands and reduced resources for coping resulting in strained parent–child interactions and relationships. Four subthemes highlighted influential factors: pandemic information, professional support, social relationships and informal support, and children's school activities. Strained parent–child interactions were particularly common in the absence of adapted pandemic information, if professional and informal support were compromised, and if the parents had dealt with school‐related changes.

Conclusions

Findings support contextual models of caregiving and a stress‐resources perspective, and emphasise the importance of adapted information and support to parents with intellectual disability during crises.

Reasonable Efforts? Child Maltreatment Investigations and Service Referrals of Parents With Ascribed Cognitive Impairments in Canada

Parents with ascribed cognitive impairment (CI) are more likely than parents without CI to have their children removed by child protective services (CPS). Inequitable access to parenting and family supports and services is thought to be a contributing factor. Utilizing data on a 3-month sample of 15,980 child maltreatment investigations across Canada, including 1,244 cases featuring parents with CI, this study investigated service referrals and non-referrals. The results of this secondary data analysis suggest that, relative to need, parents with CI are less likely to be referred for matched services, including home based\reunification services post child removal. It is unclear whether disparate rates of referral are driven by a lack of inclusive services, and/or the conflation of parental CI with perceived parenting deficits. When perceived parenting deficits are attributed to parental CI, CPS may wrongly assume that these are irremediable. The findings highlight the need for building inter-sectoral service pathways in order to render appropriate assistance to parents with CI in the performance of their childrearing responsibilities.